The Ministry of Health and Welfare yesterday announced new rules regulating living kidney exchanges between two pairs of incompatible donors and recipients who are related.
The new regulations, which were published for preview in October last year, took effect yesterday.
According to Article 8 of the Human Organ Transplant Act (人體器官移植條例), recipients of living organ donations must be relatives within the fifth degree of kinship to the donor, or their spouse.
Photo: Lai Hsiao-tung, Taipei Times
However, the act was amended in 2015 to make paired kidney exchanges possible for people who are awaiting kidney transplants, but do not meet the aforementioned requirement.
The new regulations were drafted to address concerns over the ethics of paired kidney exchanges and potential problems with illegal organ trade, said Shih Chung-liang (石崇良), director-general of the ministry’s Department of Medical Affairs.
In the past, relatives who were willing to donate their kidneys, but were incompatible with the patient had to give up the opportunity to help family members, he said.
The new regulations allow patients who have been reviewed by their hospital’s ethics committee to cross-match with other potential donors, he said.
If a match is found, the two pairs of donors-recipients and the hospitals involved may then agree on a time and date to carry out the operations after further reviews by the hospitals’ ethics committees and the ministry, he said.
While the two transplants need to take place at the same time, donors and recipients may change their minds at any point before the surgery, according to the regulations.
The new regulations increase patients’ chances of receiving kidney donations, Shih said.
The consensus among major hospitals is that kidney exchanges can be done between two pairs of donors-recipients at most, Taiwan Organ Registry and Sharing Center chief executive officer Chiang Yang-jen (江仰仁) said.
Match rates could be improved if more people registered with the center, he said.
Each year, few people in Taiwan are able to successfully receive kidney transplants mainly because Taiwanese views toward organ donation have not changed, said Leu Jyh-gang (呂至剛), a doctor in the nephrology division at Shin Kong Wu Ho-su Memorial Hospital in Taipei.
Even though living kidney donations from family members have been allowed for years, those who are willing to donate their kidneys might be dissuaded from doing so by other family members, he said.
Data from the center show that more than 7,000 people in Taiwan are waiting for kidney transplants.
Last year, there were 181 cases of deceased-donor kidney transplants and 163 cases of living-donor kidney transplants from family members, data showed.
Leu suggested that those considering paired kidney exchanges look into the condition of the donor’s kidney, as well as the risks involved beforehand.
Recipients would need to take anti-rejection medication for the rest of their lives, he said, adding that there is also a risk of acute rejection.
Donors, on the other hand, should have their kidney function checked yearly, and avoid diets and lifestyle habits that could damage their kidneys, he added.
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